| NPI | 1497957062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY L. CASEY Administrator 636-933-1793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MO 033990) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: MO 032831) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-08-22 |